Reduced mortality rates following elective percutaneous liver biopsies

Abstract

Background & aims: Estimates of complication rates following elective percutaneous liver biopsy vary and might not accurately reflect current practice. We studied mortality and complication rates, by indication, in patients after they underwent liver biopsies.

Methods: We performed a study using hospital episode statistics collected by the National Health Service in England from 1998 to 2005 of elective percutaneous liver biopsies; data were linked with those from the Office for National Statistics to determine mortality rates. Using data from 61,187 people who underwent liver biopsies, all-cause mortality at 7 and 30 days after biopsy, 7-day mortality directly related to liver biopsy, and episodes of bleeding up to 7 days after biopsy were determined.

Results: Overall all-cause mortality by 7 days after biopsy was 2 per 1000 biopsies (95% confidence interval, 1.8-2.5); this rate varied markedly by indication for biopsy, with rates as high as 12 per 1000 for patients investigated for cancer. Death within 7 days directly related to liver biopsy occurred, at most, every 1 in 10,000 biopsies in patients investigated for liver disease or abnormal liver function test results. Overall, 6 episodes of major bleeding occurred per 1000 biopsies.

Conclusions: All-cause mortality risk following elective percutaneous liver biopsy is approximately 0.2%, with a higher risk of major bleeding. Deaths directly related to liver biopsy occur approximately 1 in every 10,000 biopsies. This risk is substantially lower than that of previous reports, indicating that the safety of this procedure has improved.